TechTotes Request Form



Name:
Position:
School Name:
Shipping Street:
Shipping City:
Shipping State:
Shipping Zip:
(Address required to quote shipping charges)
Phone: (xxx-xxx-xxxx)
Email:
Dates Requested:	Checkout:	Return:

Product	Price Each Per Day	Requested Quantity
Lego Mindstorms NXT Kit (software not included)	$1.00
Latitude D630 Laptop	$2.50
Portable Printer	$2.00
Projector	$5.00
Wireless Access Point	$2.00
Camera Tripod	$0.50
Flip Video Camcorder	$1.50
iPod Nano	$1.00
Notebook Quick Cam	$0.25
Palm Video Camcorder	$2.00
Quick Cam	$0.25
Sony Cybershot Digital Camera	$1.00
Stereo Headset	$0.25